scholarly journals Thirty-year trends in the prevalence and severity of female genital mutilation: a comparison of 22 countries

2017 ◽  
Vol 2 (4) ◽  
pp. bmjgh-2017-000467 ◽  
Author(s):  
Alissa Koski ◽  
Jody Heymann
Keyword(s):  
Female Genital Mutilation ◽  
Household Survey ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Birth Cohorts ◽  
Rigorous Evaluation ◽  
Genital Mutilation ◽  
Sub Saharan ◽  
Over Time ◽  
Female Genital

IntroductionFemale genital mutilation (FGM) harms women’s health and well-being and is widely considered a violation of human rights. The United Nations has called for elimination of the practice by 2030.MethodsWe used household survey data to measure trends in the prevalence of FGM in 22 countries. We also examined trends in the severity of the practice by measuring changes in the prevalence of flesh removal, infibulation and symbolic ‘nicking’ of the genitals. We evaluated the extent to which measurement error may have influenced our estimates by observing the consistency of reports for the same birth cohorts over successive survey waves.ResultsThe prevalence of all types of FGM fell in 17 of 22 countries we examined. The vast majority of women who undergo FGM have flesh removed from their genitals, likely corresponding to the partial or total removal of the clitoris and labia. Infibulation is still practised throughout much of sub-Saharan Africa. Its prevalence has declined in most countries, but in Chad, Mali and Sierra Leone the prevalence has increased by 2–8 percentage points over 30 years. Symbolic nicking of the genitals is relatively rare but becoming more common in Burkina Faso, Chad, Guinea and Mali.ConclusionFGM is becoming less common over time, but it remains a pervasive practice in some countries: more than half of women in 7 of the 22 countries we examined still experience FGM. The severity of the procedures has not changed substantially over time. Rigorous evaluation of interventions aimed at eliminating or reducing the harms associated with the practice is needed.

scholarly journals The impact of community led alternative rite of passage on eradication of female genital mutilation/cutting in Kajiado County, Kenya: A quasi-experimental study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249662
Author(s):  
Samuel Muhula ◽  
Anthony Mveyange ◽  
Samuel Oji Oti ◽  
Martha Bande ◽  
Hellen Kayiaa ◽  
...  
Keyword(s):  
Female Genital Mutilation ◽  
Secondary Data ◽  
Sub Saharan Africa ◽  
Rite Of Passage ◽  
Genital Mutilation ◽  
Community Stakeholders ◽  
Quasi Experimental ◽  
Sub Saharan ◽  
The Impact ◽  
Female Genital

Introduction In Kenya, Female Genital Mutilation/Cutting (FGM/C) is highly prevalent in specific communities such as the Maasai and Somali. With the intention of curtailing FMG/C prevalence in Maasai community, Amref Health Africa, designed and implemented a novel intervention—community-led alternative rite of passage (CLARP) in Kajiado County in Kenya since 2009. The study: a) determined the impact of the CLARP model on FGM/C, child early and forced marriages (CEFM), teenage pregnancies (TP) and years of schooling among girls and b) explored the attitude, perception and practices of community stakeholders towards FGM/C. Methods We utilised a mixed methods approach. A difference-in-difference approach was used to quantify the average impact of the model with Kajiado as the intervention County and Mandera, Marsabit and Wajir as control counties. The approach relied on secondary data analysis of the Kenya Demographic and Health Survey (KDHS) 2003, 2008–2009 and 2014. A qualitative approach involving focus group discussions, in-depth interviews and key informant interviews were conducted with various respondents and community stakeholders to document experiences, attitude and practices towards FGM/C. Results The CLARP has contributed to: 1) decline in FGM/C prevalence, CEFM rates and TP rates among girls by 24.2% (p<0.10), 4.9% (p<0.01) and 6.3% (p<0.01) respectively. 2) increase in girls schooling years by 2.5 years (p<0.05). Perceived CLARP benefits to girls included: reduction in teenage marriages and childbirth; increased school retention and completion; teenage pregnancies reduction and decline in FGM/C prevalence. Community stakeholders in Kajiado believe that CLARP has been embraced in the community because of its impacts in the lives of its beneficiaries and their families. Conclusion This study demonstrated that CLARP has been positively received by the Maasai community and has played a significant role in attenuating FGM/C, CEFM and TP in Kajiado, while contributing to increasing girls’ schooling years. CLARP is replicable as it is currently being implemented in Tanzania. We recommend scaling it up for adoption by stakeholders implementing in other counties that practice FGM/C as a rite of passage in Kenya and across other sub Saharan Africa countries.

scholarly journals Is there a relationship between female genital mutilation/cutting and fistula? A statistical analysis using cross-sectional data from Demographic and Health Surveys in 10 sub-Saharan Africa countries

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025355 ◽  
Author(s):  
Dennis Juma Matanda ◽  
Pooja Sripad ◽  
Charity Ndwiga
Keyword(s):  
Statistical Analysis ◽  
Female Genital Mutilation ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Common Belief ◽  
Cross Sectional ◽  
Genital Mutilation ◽  
Sub Saharan ◽  
Female Genital

ObjectivesLiterature on associations between female genital mutilation/cutting (FGM/C) and fistula points to a common belief that FGM/C predisposes women to developing fistula. This study explores this association using nationally representative survey data.DesignA secondary statistical analysis of cross-sectional data from Demographic and Health Surveys was conducted to explore the association between FGM/C and fistula.SettingSub-Saharan Africa.ParticipantsWomen aged 15–49 years in Burkina Faso (n=17 087), Chad (n=17 719), Côte d’Ivoire (n=10 060), Ethiopia (n=14 070), Guinea (n=9142), Kenya (n=31 079), Mali (n=10 424), Nigeria (n=33 385), Senegal (n=15 688) and Sierra Leone (n=16 658).Main outcome measuresFistula symptoms.ResultsMultivariate logit modelling using pooled data from 10 countries showed that the odds of reporting fistula symptoms were 1.5 times (CI 1.06 to 2.21) higher for women whose genitals were cut and sewn closed than those who had undergone other types of FGM/C. Women who attended antenatal care (ANC) (adjusted odds ratio (AOR) 0.51, CI 0.36 to 0.71) and those who lived in urban areas (AOR 0.62, CI 0.44 to 0.89) were less likely to report fistula symptoms than those who did not attend ANC or lived in rural areas.ConclusionsSevere forms of FGM/C (infibulation) may predispose women to fistula. Contextual and socioeconomic factors may increase the likelihood of fistula. Multisectoral interventions that concurrently address harmful traditional practices such as FGM/C and other contextual factors that drive the occurrence of fistula are warranted. Promotion of ANC utilisation could be a starting point in the prevention of fistulas.

scholarly journals Socio-economic and demographic determinants of female genital mutilation in sub-Saharan Africa: analysis of data from demographic and health surveys

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
John Elvis Hagan ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu ◽  
Eugene Budu ◽  
...  
Keyword(s):  
Female Genital Mutilation ◽  
Health Surveys ◽  
Wealth Quintile ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Level Of Education ◽  
Genital Mutilation ◽  
Sub Saharan ◽  
Female Genital

Abstract Background Owing to the severe repercussions associated with female genital mutilation (FGM) and its illicit status in many countries, the WHO, human rights organisations and governments of most sub-Saharan African countries have garnered concerted efforts to end the practice. This study examined the socioeconomic and demographic factors associated with FGM among women and their daughters in sub-Saharan Africa (SSA). Methods We used pooled data from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 12 countries in SSA. In this study, two different samples were considered. The first sample was made up of women aged 15–49 who responded to questions on whether they had undergone FGM. The second sample was made up of women aged 15–49 who had at least one daughter and responded to questions on whether their daughter(s) had undergone FGM. Both bivariate and multivariable analyses were performed using STATA version 13.0. Results The results showed that FGM among women and their daughters are significantly associated with household wealth index, with women in the richest wealth quintile (AOR, 0.51 CI 0.48–0.55) and their daughters (AOR, 0.64 CI 0.59–0.70) less likely to undergo FGM compared to those in the poorest wealth quintile. Across education, the odds of women and their daughters undergoing FGM decreased with increasing level of education as women with higher level of education had the lowest propensity of undergoing FGM (AOR, 0.62 CI 0.57–0.68) as well as their daughters (AOR, 0.32 CI 0.24–0.38). FGM among women and their daughters increased with age, with women aged 45–49 (AOR = 1.85, CI 1.73–1.99) and their daughters (AOR = 12.61, CI 10.86–14.64) more likely to undergo FGM. Whiles women in rural areas were less likely to undergo FGM (AOR = 0.81, CI 0.78–0.84), their daughters were more likely to undergo FGM (AOR = 1.09, CI 1.03–1.15). Married women (AOR = 1.67, CI 1.59–1.75) and their daughters (AOR = 8.24, CI 6.88–9.87) had the highest odds of undergoing FGM. Conclusion Based on the findings, there is the need to implement multifaceted interventions such as advocacy and educational strategies like focus group discussions, peer teaching, mentor–mentee programmes at both national and community levels in countries in SSA where FGM is practiced. Other legislative instruments, women capacity-building (e.g., entrepreneurial training), media advocacy and community dialogue could help address the challenges associated with FGM. Future studies could consider the determinants of intention to discontinue or continue the practice using more accurate measures in countries identified with low to high FGM prevalence.

scholarly journals Girl’s Education in Africa

2020 ◽  
Author(s):  
Hadley Olivia Hobbs
Keyword(s):  
Female Genital Mutilation ◽  
Sub Saharan Africa ◽  
Government Effectiveness ◽  
Genital Mutilation ◽  
Education Participation ◽  
Sub Saharan ◽  
Female Genital ◽  
Education In Africa

Why is girls' education participation notably below average in countries throughout both North and Sub-Saharan Africa? Previous research has concluded that the low rates of girls' education in Africa are attributed to economics and more specifically wealth. While wealth needs to be addressed as a part of the discussion of issues surrounding girl's education, it does not seem to be the primary cause of low participation outcomes. I argue that culture and governance are the primary factors effecting girls' education in Africa. Moreover, government effectiveness and female genital mutilation are primary causes of the outcomes of girl's education and appear to diminish the effects of wealth.

scholarly journals The Consequences of Female Genital Mutilation on Psycho-Social Well-Being: A Systematic Review of Qualitative Research

2021 ◽  
pp. 104973232110018
Author(s):  
Sarah O’Neill ◽  
Christina Pallitto
Keyword(s):  
Female Genital Mutilation ◽  
Social Impact ◽  
Well Being ◽  
Social Consequences ◽  
Health Consequences ◽  
Genital Mutilation ◽  
The Social ◽  
Women's Lives ◽  
The Impact ◽  
Female Genital

The health consequences of female genital mutilation (FGM) have been described previously; however, evidence of the social consequences is more intangible. To date, few systematic reviews have addressed the impact of the practice on psycho-social well-being, and there is limited understanding of what these consequences might consist. To complement knowledge on the known health consequences, this article systematically reviewed qualitative evidence of the psycho-social impact of FGM in countries where it is originally practiced (Africa, the Middle East, and Asia) and in countries of the diaspora. Twenty-three qualitative studies describing the psycho-social impact of FGM on women’s lives were selected after screening. This review provides a framework for understanding the less visible ways in which women and girls with FGM experience adverse effects that may affect their sense of identity, their self-esteem, and well-being as well as their participation in society.

scholarly journals Evaluation of progress with using community conversation as a strategy to encourage district level abandonment of female genital mutilation and/or cutting in 10 districts in Ethiopia

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Ellen Alem ◽  
Emezat Hailu ◽  
Haile-leul Siyoum ◽  
Ibrahim Sesay ◽  
Lulit Mitik ◽  
...  
Keyword(s):  
Female Genital Mutilation ◽  
Behavioural Change ◽  
Household Survey ◽  
Social Convention ◽  
Health Extension Workers ◽  
Genital Mutilation ◽  
Convention Theory ◽  
Law Enforcement Officials ◽  
Document Review ◽  
Female Genital

Background: Female genital mutilation and/or cutting (FGM/C), whilst widespread, is declining in Ethiopia; 81% of 45–49-year-old women were circumcised in a 2005 survey, and 62%of 15–19-year-olds.Objectives: This evaluation examined progress in abandoning FGM/C in ten woredas(districts) where strategy based on the social convention theory had led to official declarations of abandonment and assessed if the strategy could accelerate the declining trend of the FGM/C practice in Ethiopia.Method: Quantitative and qualitative instruments collected data from a document review, a household survey (1275 households), in-depth and key informant interviews and focus group discussions.Results: Overall, there were encouraging results in terms of awareness creation and behavioural change to some extent. Sixty-nine percent of women and 41% of girls interviewed perceived a decline in the practice (range 40% – 90%) after the declaration. Seventy-six percent of women said they would not circumcise girls in the future. The involvement of influential people such as religious leaders, elders, health extension workers, and law enforcement officials in the teaching contributed immensely to the awareness creation. However, some districts reports indicated the practice had gone underground. The costs of facilitating the strategy varied from USD 3 to 7 per person, with better results where costs were higher. The abandonment events tended to costaround 25% of total costs, an area where cost efficiency can be improved.Conclusion: The evaluation has informed the dialogue around the development of the country’s first national budgeted strategy that aims to accelerate the abandonment of all harmful traditionalpractices.

The role of the SCPHN school nurse in raising awareness of female genital mutilation

2019 ◽  
Vol 14 (6) ◽  
pp. 283-288
Author(s):  
Emma Nicolaas ◽  
Dwynwen Spargo
Keyword(s):  
Support Services ◽  
Female Genital Mutilation ◽  
School Nurses ◽  
Community Leader ◽  
Evidence Based ◽  
Genital Mutilation ◽  
Raising Awareness ◽  
Over Time ◽  
Female Genital

Migration has resulted in specialist community public health nurses (SCPHN), specifically SCPHN school nurses, encountering female genital mutilation (FGM) more commonly in practice, requiring them to upskill to offer support and raise awareness ( Robinson, 2011 ). A policy was critically analysed, and a literature review conducted, to identify evidence-based strategies to enable the SCPHNSN to effectively raise FGM awareness to school-aged pupils. The findings highlighted three themes – Education, cultural influence and community leader and FGM survivor engagement, which translated into practice as a SCPHNSN-led FGM education project ( Diop and Askew, 2009 , Adeniran et al. 2015 , Galukande et al. 2015 , Raible et al. 2017 , Connelly et al. 2018 , Johnson et al. 2018 ). A project such as this would enable the SCPHNSN to raise pupil awareness, increase knowledge of support services, achieving practice decline over time.

scholarly journals Beyond will: the empowerment conditions needed to abandon female genital mutilation in Conakry (Guinea), a focused ethnography

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Marie-Hélène Doucet ◽  
Alexandre Delamou ◽  
Hawa Manet ◽  
Danielle Groleau
Keyword(s):  
Social Support ◽  
Female Genital Mutilation ◽  
Well Being ◽  
Social Pressure ◽  
Focused Ethnography ◽  
Genital Mutilation ◽  
Individual Interviews ◽  
Practice Experience ◽  
Female Genital

Abstract Background Female genital mutilation (FGM) can give rise to immediate and long-term health problems for girls/women. Numerous studies have identified the sociocultural determinants of this tradition, but so far, in a national context where FGM is highly practiced, virtually none have focused on people refusing to have their daughters cut. We therefore aimed to understand the sociocultural dynamics underlying the non-practice of FGM in Guinea, a country which has one of the most prevalent rates of this practice in the world. This research explored the demographic and sociocultural profiles of Guineans who do not practice FGM, as well as their non-practice experience in a context of high FGM prevalence and social pressure. Methods We used a “focused ethnography” methodology and conducted semi-structured individual interviews with 30 women and men from different generations (young adults, parents, grandparents) living in Conakry, Guinea. Results We found that participants 1) do not disclose their non-practicing status in the same way, and 2) have different experiences with social pressure. A typology was created to describe participants as per their various profiles and experiences, which we named as: 1) the “activists”, 2) the “discrete”, 3) the “courageous”, 4) the “strategists”. Discussion Wanting to stop practicing FGM is not enough. The main empowering conditions allowing people to enact their decision not to have their daughters undergo FGM are: benefiting from social support (positive social capital), or being financially independent from the traditional solidarity network (sufficient economic capital). We therefore recommend finding ways to increase women’s/families’ empowerment to enact their decision not to practice FGM, mainly by: 1) providing them with new sources of social support, and 2) supporting them to gain more financial independence, including through schooling and improved access to better-paid employment. Conclusions This study was the first to explore the experience of people who do not practice FGM in a context of high FGM prevalence and social pressure. The results and recommendations of this research can inform strategies for FGM abandonment and therefore contribute to improving or developing intervention strategies that promote the health and well-being of girls and women.

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